Depression for Beginners

..... of an affliction so severe that it significantly restricts a person’s ability to function fully, a crater in the mind so deep that no one can responsibly suggest it would surely go away if those victims would just square their shoulders and think more positively.....
Jeffrey R. Holland

Sunday, August 28, 2016

Attempting to compare your friend’s situation
to someone who seems worse off is not a helpful strategy. Depression isn’t
based on life circumstance. It’s brain chemistry. Someone could be living what
you would consider to be the easiest, best life ever, but the surface
impression of someone’s life is not an indication of their internal
life/feelings. Comparing their life to others with more trying life
circumstances will only make your friend feel worse.

2. “You should count your blessings.”

What
might be a helpful strategy for you will not be helpful for someone living
under the weight of depression. Thinking of all of the good things in life will
not lift the cloud of depression from your friend. It will only heap guilt on
top of their already struggling demeanor.

3. “You’re just in a funk.”

Don’t
belittle your friends struggle. By claiming that is it just a passing “funk”
you are telling your friend that their feelings are not valid. Don’t dismiss
feelings that you do not understand.

4. “Have you tried…”

Someone
living with depression does not want to be feeling the pain that they are
feeling. They have tried everything they know how to try. You
suggestions only make your friend feel silly and frustrated. If you personally
don’t live with depression, you will never know the depth of the pain and the
helplessness that your friend feels. Suggestions from someone without
depression only serve to patronize and not support.

5. “I totally understand. I get depressed sometimes
too…”

If you
think you get “depressed” sometimes, then you do not understand what depression
is. Feeling sad or upset is not the same thing as being clinically depressed.
Trying to relate to your friend who is in a situation that you have never truly
been in will not help your friend feel loved and supported.

6. “You should focus on
exercising and healthy eating!”

You should not be making recommendations about
about how to cope with a serious mental illness if you’re not a professional.
Your friend does not need another “professional” opinion. They need a friend.
Physical health is related to mental heath, but chemical imbalances in the
brain causing depression cannot be cured by going on a jog and having a salad.

7. “But you don’t look
depressed!”

Depression isn’t a style. It doesn’t
necessarily affect the viewable surface of someone. People suffering from
depression come in all ages, races, genders, occupations and orientations. You
can’t assume you understand someones feelings by how they appear to feel. Even
if your friends looks healthy and seemingly happy, you should listen to them
talk about how they really feel and believe them.

8. “You can beat this.”

Depression isn’t the same as other physical
illnesses. You can “get over it” like a cold. Asserting that your friend could
“beat” their depression assumes that they’re in control of it. Phrases that
assume your friend has power over their mental illness also assumes that they
are responsible for how they feel.

9. “Why don’t you just do
more of what you enjoy?”

When someone is depressed the things that they
would normally enjoy are no longer enjoyable. That is one of the most brutal
parts of living with depression. The passions and interests your friend once
had have lost their color. Simply crafting, or going for walks isn’t going to
cure their mental illness.

10. “You should look on the
bright side.”

Saying this implies that you do not understand
the reality of depression. There is no bright side. Living with depression
means your friend is struggling to find the bright side.

11. “Don’t I make you happy?”

Your friends depression has nothing to do with
you. Don’t assume they no longer like you or want to hang out with you because
the chemistry of their brain has changed. You’ll only make your friend feel
guilty and desperate by making their pain all about yourself.

12. “Happiness is a choice!”

Not when you’re depressed. Reducing your
friends struggle to an easy choice to be or not to be happy is overly
simplistic and offensive. They aren’t choosing to feel the way they do and they
can’t just choose not to feel that way.

Friday, December 27, 2013

By Louise from her own experience
with depression
Written for Internet Mental Health
February 1998

The following are gentle suggestions
for psychiatrists who may be treating the severely depressed. These arise from
my own experience with depression. The suggestions are given in order to make
the time of treatment and recovery as painless as possible for the depressed
individual.

First encounter. Treat the patient with the utmost
dignity and respect. The depressed person may be exceedingly despondent or
agitated. The person may be fearful and panic-stricken. The patient may
find eye contact difficult. But what the person is in this depressed state
is not what the recovered person will be. People sometimes assume a luxury
with the sick. In a way they imagine that they can treat the sick person
any way they please. This does great harm, preventing in some degree the
patient's ability to assume once again a position of respect. The
depressed person inwardly cries out: “I am not what you see.” Friends may
have come to avoid the depressed individual. Some people may have been positively
insulting. If psychiatrists treat the depressed as they would an ill
member of their own family, they may have started their recovery.

The psychiatrist should assume that the depressed
person needs to have the nature of depression fully explained. The patient
needs to hear that depression is a chemical imbalance in the brain. It is
a disease that simply happens to someone. The length of a depression may
last months or years, if it is a severe episode. Depression is a major
cause of suicide. The psychiatrist should then suggest that the best form
of treatment for depression is the use of antidepressants.

The
psychiatrist next should counter a whole range of misapprehensions that the
depressed person may have. It is highly likely that this person has shared his
or her condition with others and has received much advice. This person may also
have read a large number of books dealing with depression. The following
aspects should be described.

Right-thinking or visualization cannot heal a
depression. The depressed person may hope that this is possible but the
physical nature of the disease should be emphasized.

Will-power cannot remove depression. People may have
made the depressed person feel totally inadequate by suggesting that only
strength of will is needed.

Diet has little or nothing to do with depression.

Faith may help someone through depression and provide
an important anchor during the suffering of this disease. But it cannot
right the balance in the brain.

The psychiatrist should then describe in detail the
side-effects of the antidepressants. The depressed person needs to know
that these side-effects can be rather upsetting. The drugs do not act
quickly. The depression itself continues and may even worsen in this first
stage of treatment. The patient must receive much encouragement to stay on
the medication.

The depressed person should be allowed to come at least
weekly during the early stages of treatment. Much gentleness and patience
are needed. The patient may rebel at the side-effects that are being
experienced. Suicidal tendencies may become stronger. The depressed person
needs much affirmation of worth. Hope of recovery should be emphasized. If
the depressed person has a supportive friend, it may prove very helpful
for this individual to share the appointment time. This friend can then be
aware of the nature of the course of the disease and offer support based
on accurate information.

The psychiatrist should be willing to listen to the
description of side-effects. Even though these will gradually lessen, they
are very real to the depressed person. Smiling encouragement about what
the future will bring may be in sharp contrast to what the depressed
person is feeling.

The psychiatrist should monitor the symptoms of
depression at each meeting. If these symptoms are becoming less, the
patient should be told and given encouragement.

Depressed persons frequently go off the antidepressants
after three or four weeks. By patient and relentless effort, the
psychiatrist should get the patient to resume medication.

If the patient goes off the medication and if the
depression is worsening (especially with regard to suicidal thoughts), the
psychiatrist should make hospitalization a necessity. The mere mention of
this may suffice to encourage the depressed person to resume medication
and have the freedom of being treated as an outpatient.

As the antidepressants begin to take effect after three
or four weeks, the psychiatrist should be encouraging and hopeful. Since
the depressed person heals very slowly and there are many ups and downs,
the psychiatrist should also ask the patient about the bad times. These
remain very real and should not be overlooked. The friends of the
depressed person are impatient and expect a full and hasty recovery. The
depressed person needs someone to listen about the bad times.

Once the medication is taking effect, the psychiatrist
can move into psychotherapy. The depressed person may still be very
fearful, panic stricken, or anxious. Help with this behavior can now be
given. The depressed person knows how irrational these feelings are and
may be embarrassed to speak of them. Again these symptoms should be seen
as part of the disease and hope for recovery given.

The psychiatrist should be available until the
depressed person seems fully recovered and then available with more widely
spaced visits. Always the patient should be made aware that depression can
be healed. Depressed persons need to learn that they can recover a sense
of dignity and worth. Most importantly, they must come to believe that
they will be able to cope with life and be creative once again.

Tuesday, December 24, 2013

What is this world that I behold, wrapped in golden light? What this sense of joy that slowly arises in my heart and spreads throughout my being? What is this new surge of life, new yet old, vaguely remembered yet earnestly sought for? What is this mystery of life that wells up within, that appears in the morning and does not fade with the day? Why now do I hear birds' songs, notice the flowers, watch children laugh, see the intricate beauty of this wondrous world? Why at this time does creative energy grow within that wishes, demands expression? Why do I have confidence that time will bring some wonderful events, some challenges, and , of course, some sorrows and not wish to flee away but to stay and to live?

It was not always thus in recent months. Darkness has been my companion, dwelling at times within, stalking my steps from behind, a dark specter threatening, grasping, invading. This gloom, this monster, so poisonous, so pervasive, spreading its subtle and acid venom through my being, bringing senseless tears to my eyes, apathy to my body and mind, a longing for death to my heart. Easily it removes all joy from life. It casts a gray mist over all that is lovely or innocent, makes nothing attractive, nothing appealing. It gradually crushes all confidence, sense of worth, and finally makes life so intolerable that death seems sweet.

Where has the darkness fled as I face this new day? Is it still a hidden companion, ready to take hold of me at any moment when I least suspect its arrival? Can I be sure that this monster has been defeated or will it ever lie in wait for me, coloring all my experiences with silent fear and dreadful anticipation of the worst? Means have been taken to drive the darkness out. Medication works its wonders, discussion with others opens new windows on life and the difficult roads it may ask me to tread. More than this I cannot expect. But within a loud voice cries out:. “Never darkness again! Never depression! Never, never, never!”

Whether the darkness will return or not, I cannot know. All that I can do now is to be faithful, faithful in taking the medication I need, faithful in trusting that life has a meaning and purpose for me, a unique individual, the only one such in this universe at any time. I can also use all the strength of my will to affirm what was slowly stolen from me. What was this? Essentially a sense of life. Depression crushes and destroys this. But life is something that cannot die. By destroying the body, one makes life depart but as long as it is held safe within the shell of the body, it will not be overcome.

When depression lifts, life returns. It begins to show off its beauties everywhere. What before could bring pain-the sight of people vibrantly alive, eagerly taking up activities, laughing, enjoying family and friendships, creatively spending their days-now attracts. Nature appears to be magnificent both in its grand manifestations and in its intricate subtleties. More importantly, the beauties inside one's own being start to seem real. “I can like myself.” “I can even love myself.” “I too am a child of the universe, wondrous in my very existence.” With life welling up within once more, the eyes look outward again. The loveliness of others is recognized. The sweet smile of that friend. The infectious laugh of that stranger. The grace of the runner. The strength of the builder. The skill of those who work with their hands. The attractive wisdom of the old. The potential of the young.

Once again light pervades the world. It is not that the darkness of suffering and pain has disappeared from view. This darkness is still present and calls aloud for redress. But now the darkness is not within nor is it a close companion of each moment. Somehow, in some mysterious way, life has reasserted its presence. One could dance and sing for joy: “I'm alive! I'm alive!” Joy comes with the morning and this morning is sheer joy.

By Louise from her own experience with depression Written for Internet Mental Health May 1998

Monday, November 25, 2013

Today

Barbara: Hi Jane, How are you? You look a little sad, Is everything alright?

Jane: Oh, it's my fibromyalgia, it's acting up.

Barbara: I'm so sorry, my mother had fibromyalgia and I know it is painful. Is there anything I can do?
Jane: No, I don't think so. Sometimes it so painful, it's hard to function.

Jane: Barbara thank you for your concern, Sometimes just talking about it with someone who cares, makes it easier to bear.

This dialog could be repeated over and over again, with different people, with different personal physical complaints.

Jane could have had an accident and broke a bone, or just been to the doctor and found out she is diabetic or has a malignant tumor. This conversation is repeated over and over. It wouldn't matter if Barbara was the Principle of the school where Jane work. If that were case Barbara would have said something like: Please remember Jane you have sick leave, please use them whenever it's necessary. And above all don't worry about your job.

Future

Dave: John, how are you? you look a little down.

John: Yes, I am having trouble with the deep crater in my mind.

Dave: I am so sorry. Have you been to the doctor? I understand that medication can help. Is it MMD? I think that means Major Depressive Disorder.

John: Yes it is, And you know, it hasn't been too long ago, that if you had asked about how I felt, I would have said that I was Depressed, or maybe say nothing, because, I didn't know of a way to express what I was going through. The normal response to telling someone that you were depressed was, "Ok! you'll get over it. I always do." Or the boss might say: "Come on, show some backbone, Pull yourself up by your bootstraps. and then with a chuckle, Everyone has to pull their load."

Dave: Yea I know, I might not have said anything, but I would sure think it.

John: It seems a marvel to me that this change in understanding could ever happen. You asked about Medication, I am now going through the phase where different medication is tried. The Doctor said, There is a good number of medications that we know will help, But knowing which combination, is the problem, because MMD is a little different in each person.

So I try a pill to see if it makes any difference in how I feel. If it doesn't I stop taking that pill and try a different kind. It's kind of a guessing came. Trying different pill combinations until the right one is found combination is found.

Dave: That sounds like it might take some time.

John: Yes it does. I have a friend who has had MMD for 14 years. He said the finding of the right combination started in 1999 until just recently, here in 2013.

Dave: Gemanetly, how did he survive? You mean finding the right pills might take years until you are better? Do the doctors know what causes MMD?

John: Yes, there can be several causes. He says that mine is a chemical problem in the brain.

Dave: Chemical, I would have never thought, Can you explain it to me?

John: Yes I probably could but I think I'll let you read about it on this card that I carry.

At the most basic level, nobody really knows what causes depression. The dominant theory is that it is a result of low levels of certain neurotransmitters (messenger chemicals that carry signals from one nerve cell to the next) in the brain. This is called the 'monoamine theory' of depression — monoamines being the group of chemicals that these neurotransmitters belong to. The neurotransmitters thought to be involved are serotonin (which helps regulate emotion, sleep and appetite), noradrenaline (which is linked to arousal and alertness), and dopamine (which is associated with pleasure and reward). People with depression are known to have lower brain levels of these chemicals, and drugs that elevate them can help lift mood.

So the theory makes sense. But it is not known for sure whether monoamines are the primary cause of depression, or whether other factors are causing both the lowered neurotransmitter levels and the depression. William Styron

John: I had to read it twice and really concentrate before I understood it. That is really interesting, I had no idea. So it's something like the pancreas not working correctly and causing Diabetes. My Uncle is a diabetic, and they explained about the pancreas.

John: There are other problems caused by misunderstanding my problem. The world just used the word Depression. It causes a lot of problems because doesn't spell it out. To most depression means, a down day. You know like, coming home and finding a letter from the IRS.

Dave: Yea that would depress anyone.

John: Well, that kind of Depression is not MDD. It's the type that you get over.

Friday, November 15, 2013

as Reported in the journal PLOS Medicine. (POLS Public
Library of Science).

Reported by Helen Briggs of BBC News.

The study compared clinical depression with more than 200 other diseases
and injuries as a cause of disability. Globally, only a small proportion of
patients have access to treatment, the World Health Organization says.

Depression is a big problem and we definitely need to pay more attention
to it than we now are.

There's lots of stigma we know associated with mental health.

The data - for the year 2010 - follows similar studies in 1990 and 2000
looking at the global burden of depression.

Commenting on the study, Dr Daniel Chisholm, a health economist at the
department for mental health and substance abuse at the World Health
Organization said depression was a very disabling condition.

"Around the world only a tiny proportion of people get any sort of
treatment or diagnosis."

Major
Depressive Disorder is the leading cause of disability in the U.S. for ages
15-44.

Major
depressive disorder affects approximately 14.8 million American adults, or
about 6.7 percent of the U.S. population age 18 and older in a given year.

While
major depressive disorder can develop at any age, the median age at onset is
32.

Major
depressive disorder is more prevalent in women than in men.

WebMD asks:How Many in U.S. Are Depressed?

CDC Says 9% of Adults Are Depressed at Least
Occasionally; 3.4% Suffer From Major Depression

Anxiety and Depression Association of America

Anxiety disorders are the most common mental
illness in the U.S., affecting 40 million adults in the United States
age 18 and older (18% of U.S. population).

Mental
Health America

Depression is a chronic illness that exacts a
significant toll on America's health and productivity. It affects more
than 21 million American children and adults annually and is the leading
cause of disability in the United States for individuals ages 15 to 44.

CDC: One In 20 Americans Depressed

More than one in 20 Americans aged 12 and older are
depressed, according to the latest statistics.

Of them, 80% report some level of functional impairment because of their
illness, with 27% reporting that it is extremely difficult to work, get things
done at home, or get along with others because of the symptoms of their
depression.